Eyelid burn: first aid

Corneal and conjunctival burns can be severe, especially after exposure to concentrated acids or alkalis.

The eyelids are washed with a sterile isotonic solution, after which an antibacterial ointment is placed under them.

Burned areas should be immediately rinsed with plenty of water or, if available, with 0.9% sodium chloride solution. The eye can be anesthetized with one drop of 0.5% proparacaine solution, but rinsing should not be delayed; the eye should be rinsed for at least 30 minutes. Some authors suggest rinsing acid or alkali burns for 1-2 hours, while others suggest measuring the pH of the conjunctiva with litmus paper and continuing rinsing until the pH is neutralized.

The conjunctival sac is then swabbed to remove any trapped particles. The upper portion of the conjunctival sac is inspected for chemical residue by double eversion of the eyelids.

Chemical burns of the iris are treated with instillation of long-acting cycloplegics (e.g., a single dose of 1% atropine). In cases of corneal epithelial defects, antibiotic ointments (e.g., 0.3% ciprofloxacin) are used. After the first wash, local anesthetics should be avoided; significant pain can be relieved with paracetamol with or without oxycodone.

To preserve vision and prevent serious complications such as uveitis, globe perforation, and eyelid deformity, severe chemical burns should be treated by an ophthalmologist. Patients with severe ocular redness, avascular areas of the conjunctiva, or conjunctival or iris epithelial defects identified by fluorescent staining should be examined by an ophthalmologist within 24 hours.

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